For decades, methadone has been used to “treat” addiction to opiates of all kinds, from street-level heroin and morphine to prescription opioids. In the US, over 250,000 addicts and in the UK over 150,000 people are enrolled in methadone programmes – and this could expand.

By switching their destructive, life-consuming addiction to a nice, clean, once-a-day dose of methadone, addicts hope they will escape the dangers of the street-drug culture, and regain a normal life. But methadone patients soon find they are trapped in a new prison – the methadone prison. And, as any experienced detox clinician can tell you, methadone can be a far worse prison than any other opiate when someone wants to detoxify and get drug-free.

The need for an effective methadone detox protocol that works for all types of methadone dependent patients, especially those on high doses of 100s of mgs per day, has never been greater. As free methadone pours out of methadone clinics, and prescription methadone pours out of pharmacies for pain patients, methadone is the fastest-growing cause of drug poisoning and overdose deaths.

According to the US National Center for Health Statistics, methadone overdose deaths increased 500% between 1999-2005, from under 800 to almost 4,000 deaths a year. In England and Wales, methadone is the second-greatest cause of drug deaths; in Scotland, it is the leading cause of drug deaths.

DANGEROUS METHADONE 'HALF-LIFE'

The main problem is methadone’s half-life. Intoxication and pain relief both disappear before the drug has cleared from the body. Recreational users, addicts and pain patients can assume the drug has worn off and use more methadone. The tragic results can be overdose, coma, respiratory failure and death. But the well-known methadone half-life offers a clue to creating an effective detoxification protocol. A successful detox programme must address this important factor to minimise withdrawal symptoms and speed healing.

Other clues abound in science. Clinicians who care to examine the literature of addiction, biological function, nutrition, hydration and so on, will begin to comprehend better solutions than “take this drug three times a day and call me in a week” kind of detox – which for high-dose methadone is impossible.

METHADONE DETOX AND METABOLISM

Novus’ search began for detox protocols that would work equally for all types of patients in reasonable health: age, gender, race, weight, substance dependencies, level of doses, and so on. It began with a couple of basic premises.

First, almost no one wants to be addicted to any substance, including a “treatment” drug such as methadone. So many patients will look for a way to be drug-free and will pitch in and work for it when they get the right kind of assistance in a caring, non-judgmental environment.

Second, everyone’s metabolism is different, so no two people withdraw from a substance in the same way or in the same period of time. Their assistive needs – medication, nutritional, psychological, etc – are unique. To ensure success, these must be both discovered and met.

Methadone clears one body faster or slower than another, and lasts longer than many other opiates/opioids. These unique metabolic rates also mean that assistive medications during the detox process, such as other opiates or buprenorphine, will be metabolised at different rates by different patients. What might help one could harm another, depending on when it is administered. Timing is critical and different for each patient.

HYDRATION'S ROLE

Another factor, hydration, was recognised early on as a critical factor in the detox process. When it was discovered that dehydration is common, almost the norm even for “healthy” people, it became a vital part of the Novus detox protocol. It is simple to give patients water several times a day!

Gastrointestinal absorption factors also differ from patient to patient. Many cannot absorb liquids or nutrition adequately via normal channels. And detox can cause stomach upset and other digestive complaints. To solve this problem, intravenous liquids have become standard for every patient, especially in the earlier stages of detox. Vitamins, minerals, amino acids, neurotransmitters and antioxidants are all added to the IV bag, to help boost health and the immune system along with proper hydration.

Other “helper” substances, such as herbal preparations and homeopathic medicines, are provided as needed. Later in the withdrawal process, when the methadone detox patient is able to tolerate it, buprenorphine is introduced as an assistive medication.

MEDICAL MONITORING 24/7

The fact that every patient has a unique metabolic rate, health level and many other needs led the Novus team to an inescapable conclusion: the only approach that ensures success, regardless of the level of methadone dosage, must include all the above medically-valid factors. It must also include a nursing staff trained to monitor and manage patient symptoms 24 hours a day, seven days a week, adjusting and tweaking all factors throughout the detoxification period. Doing this with clinical accuracy means that detoxification of high-dose methadone is not just a possibility: it is a certainty.

It is untrue that addicts can be on dosages “too high to be detoxed” and thus it is inhumane to refuse to detox them. This situation has left countless thousands of methadone patients trapped in the methadone prison. It is a sad state of affairs, because the technology for high-dose methadone detox is not some mysterious process or miraculous feat of alchemy. It is based on sound science, a lot of trial and error and attention to detail, and a deep and abiding willingness to help.

2 comments

Great insight. And please let’s continue to get the message out. But remember that Methadone, Suboxone, Naltrexone, etc. are good medicines to use for detoxification and not long term but an appropriate frame of time. There is a point in time where methadone programmes take ones life.

I really enjoyed your insights into the methadone nightmare, for the patient and family. my daughter has struggled with addiction issues for almost ten years and for the last three was put on methadone treatment to “cure” her addiction issues. she is almost thirty and her life has spiraled out of control. can’t work anymore, has seizures, can’t find insurance, at the mercy of inadequate state run facilities. family has run out of resources to help. without insurance we r at a lost of what to do. is there any trials or free treatments available for someone at their wits end?